Transmission Possibility of COVID-19 via Surgical Smoke Generated by the Use of Laparoscopic Approaches: A Subject of Debate During the Pandemic.

ABSTRACT

Background: The smoke created by energy-based devices during surgery may have the potential to transmit viral components to operating room staff. The COVID-19 pandemic has changed staff safety regulations. However, it is not clearly understood whether it can be transmitted via surgical smoke. Laparoscopic approaches have become the standard surgical procedure in many cases, but some of previous investigations have advised to pretermit these approaches due to high risk of COVID-19 transmission. Materials and Methods: We reviewed the English literature that were indexed in the PubMed, Google Scholar, and Scopus databases by using key words including Virus, viral transmission, surgical smoke, surgical plum, laparoscopy, and COVID-19 both solely and in two-word combination. A total of 87 articles were found relevant, and after reviewing the abstract, 33 articles were shortlisted and summarized. Results: Previous studies have focused on different surgical instruments that generate smoke, methods to collect and analyze the smoke and to understand the implications of its exposure after an analysis. A total of 9 out of 11 studies on the potential transmission of human papilloma virus through surgical smoke found evidence in favor of transmission. There were studies on the possible transmission of HIV, hepatitis B virus, and Sabin poliomyelitis vaccine virus 2. Conclusion: We do not believe that laparoscopic procedures may have extra risk for COVID-19 transmission compared with the open procedures, but it is always advised that the operating room staff adhere to the safety instructions during the COVID-19 pandemic.